Labial ulcers as initial manifestation of acute EBV infection in a non-sexually active teenage girl.
Anna Papazoglou, Vassiliki Konstantinidou, Elpidoforos Mantadakis
220 BETWEEN COLLEAGUES
Stelios Antoniadis
222 BOOK PRESENTATION
Stelios Antoniadis
224 RECENT PUBLICATIONS
226 INSTRUCTIONS TO AUTHORS
Τάσος
Doppler (57).
(extracorporeal membrane oxygenation
COVID-19 (59).
= continuous venovenous hemofiltration) (61).
Περιορισμόςχρήσηςαντιβιοτικώνγια
1.Downes JJ. The historical evolution, current status, & prospective development of pediatric critical care. Crit Care Clin 1992; 8: 1 – 22
2.Leclerc F, Lacroix J. Histoire de la réanimation pédiatrique francophone Elsevier Publisher 2022
3.Berlin CM. The pediatric Intensive Care Unit. Med Ann District Columbia 1970; 39: 483 –486
4.Horak RV et al. Pediatric Acute Lung Injury & Sepsis Investigator’s (PALISI) Network. Growth & Changing Characteristics of Pediatric Intensive Care 2001–2016. Crit Care Med. 2019; 47: 1135 – 1142
5.Χατζής
14/3/1987
6.Papas C, Vavalea S, Kapiki A, Kourakis G, Papadea E, Hatzis A. Respiratory failure in bronchiolitis. 1st International Symposium on the Intensive Care of Children 23-25/9/1981
7.Παπαδάτος
9.Χατζής Α. Η
Χρονικά 1996; 19: 623 – 626
10.Χατζής Α. ΜΕΘ παιδιών: Οι «μικροί ήρωες». HealthReport 10/4/2023
11.Χατζής Α, Κεχρής Ι, Κομνός Α, Μπαλτόπουλος Γ. Οι σημερινές ανάγκες σε κλίνες ΜΕΘ:
προσέγγιση! Medispin 16/12/2020
Ζ,
14.Hatzis A, Livanios S, Dogani K, Papadatos J. Management of severe airway obstruction Intensive Care Medicine 1987; 13: 134/464
15.McVernon J, Slack MPE, Ramsay ME. Changes in the epidemiology of epiglottitis following introduction of Hemophilus influenzae type b (Hib) conjugate vaccines in England: a comparison of two data sources Epidemiol Infect 2006; 134: 570 – 572
16.Hatzis A, Sianidou L, Dogani K, Papadatos J. Management & outcome of children with respiratory distress or failure 23rd Annual Meeting Societas Europaea Physiologiae Clinicae Respiratoriae 20-24/6/1988
17.Σιανίδου
24-25/6/1989
18.Hatzis A, Gionis D, Kalabalikis P, Vassilopoulos A, Sianidou L, Papadatos J, Saxoni – Papageorgiou F. Admissions of children with status asthmaticus in a PICU. European Pediatric Respiratory Society Meeting 15/6/1990
19.Χατζής Α. Status asthmaticus 6ο
& 6ο
9-11/10/2015
20.Mercier JC, Beaufils F, Hartmann JF, et al. Hemodynamic patterns of meningococcal shock in children. Crit Care Med 1988; 16: 27 – 33
21.Hatzis A, Zavras N, Kalabalikis P, Briassoulis G, Paraschou D, Narlioglou M. Hemodynamic monitoring with pulse contour cardiac output (PiCCO) in children with meningococcal shock Intensive Care Medicine 1999; 25: 267
22.Hatzis A, Kalabalikis P, Zavras N, Narlioglou M, Briassoulis G. Meningococcemia in children: clinical experience of 90 cases Pediatr Critical Care Med 2000; 1: 22
23.Chabria D & Anjankar A. An overview of meningococcal disease’s: recent diagnostic & treatment model. Cureus 2023; 15:
24.Stefanelli et al An outbreak of severe invasive meningococcal disease due to a capsular switched Neisseria meningitidis hypervirulent strain B:cc 11 Clinical Microbiology 2019; 25: 111 – 114
25.Τσουμάκας
30.Χατζής
Iatronet 28/02/2023
31.Vasilopoulou M, Koutsaftiki C, Giannouli O, Mpeka Z, Paraskevoulakos A, Papavasiliou A & Sianidou L Psychiatric disorders in adolescents mimicking emergent neurologic conditions. 24th Annual Meeting of the European Society of Pediatric & Neonatal Intensive Care, 12-15/6/2013
32.Σιανίδου
34.Kosmidis H, Sianidou L, Hatzis A, Papadatos J, Varvoutsi M, Baka M. The role of PICU in the management of children with cancer XX Meeting of the International Society of Pediatric Oncology 22-26/8/1988
35.Briassoulis G, Hatzis T, Paphitis C, Stinios J. Acute spontaneous pneumo mediastinum in a child with Hodgkin’s disease & pulmonary fibrosis
36.Mavrommati P, Ladis V, Lagona E, Giannaki M, Raftopoulou A, Hatzis A. ARDS in a patient with homozygous beta-thalassemia due to yersiniosis Intensive Care Medicine 1999; 25: 226 – 229
37.Χατζής
HealthReport 17/5/2022
38.Camporesi et al Impact of COVID-19 pandemic on Pediatric Intensive Care Unit (PICU) visiting policies: a worldwide survey J Ped Intensive Care 2015
39.Feldstein et al Multisystem Inflammatory Syndrome in U.S. children & adolescents N. Engl. J. Med 2020; 383: 334 – 346
40.Giacalone M, Scheier E, Shavit I. Multisystem inflammatory syndrome in children (MISC): a mini-review Int. J. Emerg. Med 2021;14: 50
41.Guy R et al. Increase in invasive group A streptococcal infection notifications, England, 2022. Euro Surveillance 2023; 28: 2200942
42.ΕΟΔΥ:
43.Cantarutti A et al Influenza vaccination effectiveness in pediatric “healthy” patients: a population-based study in Italy Vaccines 2022; 10: 582
44.Topalidou X, Kalergis AM & Papazisis G Respiratory Syncytial Virus Vaccines: A Review of the Candidates & the Approved Vaccines Pathogens 2023; 12: 1259
45.Χατζής
1994; 97: 113 – 120
46.Andersen EW, Ibsen B. The anesthetic management of patients with poliomyelitis and respiratory paralysis. Br Med J. 1954; 1: 786–788
47.Kneyber MC et al Recommendations for mechanical ventilation of critically ill children Intensive Care Medicine 2017; 43: 1764 – 1780
48.Corrado A, Gorini M, Villella G, De Paola A. Negative pressure ventilation in the treatment of acute respiratory failure: an old non-invasive technique reconsidered. Eur Respir J 1996; 9: 1531 – 1544
49.Παράσχου Δ, Χατζής
1998; 61: 25 – 31
50.Jouvet P, Thomas NJ, Willson DF, et al. Pediatric acute respiratory distress syndrome: consensus recommendations from the pediatric acute lung injury consensus conference. Pediatr Crit Care Med. 2015; 16: 428 – 439.
51.Albuali WH, Singh RN, Fraser DD, et al. Have changes in ventilation practice improved outcome in children with acute lung injury? Pediatr Crit Care Med 2007; 8: 324 – 330.
52.Essouri S, Carroll C. Noninvasive support & ventilation for pediatric acute respiratory distress syndrome. Pediatr Crit Care Med. 2015; 16: S102 – 110
53.Pham TM, O’Malley L, Mayfield S, Martin S, Schibler A. The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis Pediatric Pulmonology 2015; 50: 713 – 720
54.Ranjit S & Kissoon N Bedside echocardiography is useful in assessing children with fluid & inotrope septic shock Indian J Crit Care Med 2013; 17: 224 – 30
55.Skardoutsou A, Sarri Z, Tsapra H, Papadatos J, Hatzis A. Non-traumatic coma in children XIX World Congress of Pediatrics 23-28/7/1989
56.Χατζής
& ΦΡΟΝΤΙΔΑ 1990; 5: 10 – 18
57.Verlhac S Transcranial Doppler in children Pediatr Radiol 2011; 41: 153 – 165
58.Rasidakis A, Hatzis A, Dogani K, Sarri Z, Kostopoulos C, Kleanthous A, Iordanoglou J. Partial extracorporeal lung support with continuous arteriovenous hemofiltration modified system in severe ARDS. 1st European Symposium on Extracorporeal Lung Support 22-24/5/1991
59.Watanabe A et al Extracorporeal Membrane Oxygenation in Children With COVID-19 Pediatr Crit Care Med. 2023; 24: 406 – 416
60.Hatzis A, Michelis K, Sianidou L, Stefanidis K, Dogani K, Mitsioni A Continuous arteriovenous hemofiltration in acute renal failure V Meeting European Society of Pediatric Intensive Care 29/8 – 2/9/1990
61.Goldstein SL et al Outcome in Children Receiving Continuous Venovenous Hemofiltration Pediatrics 2001; 107: 1309 – 1312
62.Πετράκη
63.Kalabalikis P, Hatzis T, Papadatos J, Gionis D, Danou F, Vlachos P. Paraquat poisoning in a family Vet Human Toxicology 2001; 43: 31 – 33
64.Vasudevan A Peritoneal dialysis for the management of pediatric patients with acute kidney injury Pediatric Nephrology 2017; 32: 1145 – 1156
65.Beaufils F. La Réanimation en début de vie Laennec 2006 ; 54 : 6 – 16
66.Egbuta C & Mason KP Current State of Analgesia and Sedation in the Pediatric Intensive Care Unit J Clin Med 2021; 10: 1847
67.Χατζής
68.Briassoulis G, Zavras N, Hatzis T. Effectiveness & safety of a protocol for promotion of early intragastric feeding in critically ill children. Pediatric Critical Care Medicine 2001; 2:
113 – 121
69.Briassoulis G, Natsi L, Tsorva A & Hatzis T. Prior antimicrobial therapy in the hospital & other predisposing factors influencing the usage of antibiotics in a pediatric critical care unit
Annals of Clinical Microbiology & Antimicrobials 2004; 4:
70.Morrow BM. Building a culture of early mobilization in the Pediatric Intensive Care Unit, a nuts & bolts approach Transl Pediatr 2021; 10: 2845 – 57
71. Clark M, Carleton M, Kelleher A & Noviski N. A child's experience as a patient in a pediatric intensive care unit: what we learned through their drawings & narratives
72.Adegboro CO et al Artificial Intelligence to Improve Health Outcomes in the NICU & PICU: A Systematic Review. Hosp Pediatr 2022; 12: 93 – 110
Spectrum Disorder, virtual reality, augmented reality, applications for mobile phones”.
stavroulalexiadou@ gmail.com
Correspondence
Stavroula Alexiadou
M. +3069827875
e-mail: stavroulalexiadou@ gmail.com
New technological interventions in supporting children with high-functioning Autism Spectrum Disorder
Stavroula Alexiadou, Melpomeni Rounti, Sofia Sotiropoulou, Pinelopi Dragoumi, Dimitris Zafeiriou
Abstract
Background: The present literature review focuses on presenting and analyzing the results of research on technological interventions for children with high-functioning autism spectrum disorder to improve their daily lives.
Methods: A Google Scholar and Pubmed search was conducted using the following keywords: "autism spectrum disorder, virtual reality, augmented reality, mobile phone applications". The retrieved articles were analyzed according to the age of the participants, the technological device used for rehabilitation and the level of functionality. Specifically, virtual reality, augmented reality, mobile phone applications and their effects on high-functioning children on the autism spectrum are analyzed. For each of these new technologies, the focus will be on social behavior and interaction, educational learning interventions and emotion recognition.
Results: The positive results of the three technological tools in the above-mentioned areas and their contribution to improving the quality of life and everyday life of autistic people are listed. Finally, the potential problems and risks that may arise from the use of these technologies are highlighted, as well as where future research design of such interventions should focus.
Stavroula Alexiadou
Melpomeni Rounti
Sofia Sotiropoulou
Dimitris Zafeiriou
Interdepartmental Postgraduate Studies Programme (D.P.M.S.), "Neurosciences, Neurolinguistics and Applications", Aristotle University of Thessaloniki. School of Medicine, Faculty of Medicine
Pinelopi Dragoumi
Dimitris Zafeiriou
1st Pediatric Clinic of the Aristotle University of Thessaloniki, Hippocrates Hospital of Thessaloniki
Conclusions: As the field of technology continues to develop, it promises to open up new possibilities and improve the quality of life for people with ASD in ways never before possible.
Key words: Autism Spectrum Disorder, virtual reality, augmented reality, applications for mobile phones.
2.2 Χρήση Smartglasses AR (Augmented Reality)
(π.χ. Awesomely Autistic Test, ABA DrOmnibus for parents).
(π.χ. Prism, OTSIMO: Special education ABA therapy autism game),
(π.χ. Autism iHelp – Play)
(π.χ. LetMeTalk: Free AAC Talker)
Moving Meditations for Kids with Autism).
Βιβλιογραφία
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 2013
2. Koumpouros Y, Kafazis T. Wearables and mobile technologies in autism spectrum disorder interventions: A systematic literature review, Research in Autism Spectrum Disorders. 2019;66:101405.
3. Rehman IU, Sobnath D, Nasralla MM, Winnett M, Anwar A, Asif W, et al. Features of mobile apps for people with autism in a post covid-19 scenario: Current status and recommendations for apps using AI. Diagnostics. 2021;11(10):1923.
4. Boraston Z, Blakemore S. The application of eye‐tracking technology in the study of autism, The Journal of Physiology. 2007;581(3):893–898.
5. Bekele E, Zheng Z, Swanson A, Crittendon J, Warren Z, Sarkar N. Understanding how adolescents with autism respond to facial expressions in virtual reality environments, IEEE Transactions on Visualization and Computer Graphics. 2013;19(4):711–720.
6. Kumari S, Polke N. Implementation issues of augmented reality and virtual reality: A survey, International Conference on Intelligent Data Communication Technologies and Internet of Things (ICICI). 2018;26:853–861.
7. Mesa-Gresa P, Gil-Gómez H, Lozano-Quilis JA, Gil-Gómez JA. Effectiveness of Virtual Reality for Children and Adolescents with Autism Spectrum Disorder: An Evidence-Based Systematic Review. Sensors (Basel). 2018;18(8):2486.
8. Albiol-Pérez S, Gil-Gómez JA, Muñoz-Tomás MT, Gil-Gómez H, Vial-Escolano R, LozanoQuilis JA. The Effect of Balance Training on Postural Control in Patients with Parkinson's Disease Using a Virtual Rehabilitation System. Methods Inf Med. 2017;56(2):138-44.
9. Freitas JRS, Velosa VHS, Abreu LTN, Jardim RL, Santos JAV, Peres B, et al. Virtual Reality Exposure Treatment in Phobias: a Systematic Review. Psychiatr Q. 2021;92(4):1685-710.
10. Pennington RC. Computer-assisted instruction for teaching academic skills to students with autism spectrum disorders: A review of literature. Focus on Autism and Other Developmental Disabilities. 2010;25(4);239–248.
11. Williams KR. The Son-Rise Program intervention for autism: prerequisites for evaluation. Autism. 2006 Jan;10(1):86-102.
12. Fernández-Herrero J, Lorenzo-Lledó G, Carreres AL. A bibliometric study on the use of virtual reality (VR) as an educational tool for high-functioning autism spectrum disorder (ASD) children. Contemporary Perspective on Child Psychology and Education. 2018 Jan:59- 81.
13. Parsons S. Learning to work together: Designing a multi-user virtual reality game for social collaboration and perspective-taking for children with autism. International Journal of Child-Computer Interaction. 2015;6:28–38.
14. Herrero JF, Lorenzo G. An immersive virtual reality educational intervention on people with autism spectrum disorders (ASD) for the development of communication skills and problem solving. Education and Information Technologies. 2019;25(3):1689–1722.
15. Zhao J, Zhang X, Lu Y, Wu X, Zhou F, Yang S, et al. Virtual reality technology enhances the cognitive and social communication of children with autism spectrum disorder. Front Public Health. 2022;10:1029392.
16. Saadatzi MN, Pennington RC, Welch KC, Graham JH. Small-Group Technology-Assisted Instruction: Virtual Teacher and Robot Peer for Individuals with Autism Spectrum Disorder. J Autism Dev Disord. 2018;48(11):3816-30.
17. Shahab M, Taheri A, Mokhtari M, Shariati A, Heidari R, Meghdari A, et al. Utilizing Social Virtual Reality Robot (V2R) for music education to children with high-functioning autism. Education and Information Technologies. 2021;27(1):819–843.
18. Pino MC, Vagnetti R, Valenti M, Mazza M. Comparing virtual vs real faces expressing
emotions in children with autism: An eye-tracking study. Education and Information Technologies. 2021;26(5):5717–5732.
19. Tsai WT, Lee IJ, Chen CH. Inclusion of third-person perspective in cave-like immersive 3D virtual reality role-playing games for social reciprocity training of children with an autism spectrum disorder. Universal Access in the Information Society. 2020;20(2):375–389.
21. Abou El-Seoud S, Halabi O, Geroimenko V. Assisting individuals with autism and cognitive disorders: An augmented reality-based framework. International Journal of Online and Biomedical Engineering (iJOE). 2019;15(04):28
22. Ramdoss S, Lang R, Mulloy A, Franco J, O’Reilly M, Didden R, Lancioni G. Use of computer-based interventions to teach communication skills to children with autism spectrum disorders: A systematic review. Journal of Behavioral Education. 2010; 20(1):55-76.
23. Ramdoss S, Machalicek W, Rispoli M, Mulloy A, Lang R, O’Reilly M. Computer-based interventions to improve social and emotional skills in individuals with autism spectrum disorders: A systematic review. Developmental Neurorehabilitation. 2012;15(2):119-135.
24. Sahin N, Keshav, N Salisbury J, Vahabzadeh A. Safety and lack of negative effects of wearable augmented-reality social communication aid for children and adults with autism. Journal of Clinical Medicine. 2018;7(8):188.
25. Berenguer C, Baixauli I, Gómez S, Andrés M D, De Stasio S. Exploring the impact of augmented reality in children and adolescents with autism spectrum disorder: A systematic review. International Journal of Environmental Research and Public Health. 2020;17(17):6143.
26. Keshav NU, Salisbury J P, Vahabzadeh A, Sahin N T. Social communication coaching Smartglasses: Well tolerated in a diverse sample of children and adults with autism. JMIR mHealth and uHealth. 2017; 5(9): e140.
27. Liu R, Salisbury JP, Vahabzadeh A, Sahin NT. Feasibility of an autism-focused augmented reality Smartglasses system for social communication and behavioral coaching. Frontiers in Pediatrics. 2017;5.
28. Fournier KA, Hass CJ, Naik SK, Lodha N, Cauraugh J H. Motor coordination in autism spectrum disorders: A synthesis and meta-analysis. Journal of Autism and Developmental Disorders. 2010;40(10):1227-1240.
29. Nekar DM, Kang H, Alao H, Yu J. Feasibility of using multiplayer game-based dual-task training with augmented reality and personal health record on social skills and cognitive function in children with autism. Children. 2022;9(9):1398.
30. Ameis SH, Blumberger DM, Croarkin PE., Mabbott DJ, Lai MC, Desarkar P. et al. Treatment of Executive Function Deficits in autism spectrum disorder with repetitive transcranial magnetic stimulation: A double-blind, sham-controlled, pilot trial. Brain stimulation. 2020;13(3):539-547.
31. Yee HS. Mobile technology for children with autism spectrum disorder: Major trends and issues. 2012 IEEE Symposium on E-Learning, E-Management and E-Services. 2012.
32. Leung PW, Li SX, Tsang CS, Chow BL, Wong WC. Effectiveness of Using Mobile Technology to Improve Cognitive and Social Skills Among Individuals with Autism Spectrum Disorder: Systematic Literature Review. JMIR Ment Health. 2021;8(9):e20892.
33. Vlachou J, Drigas A. Mobile technology for students & Adults with autistic spectrum disorders (ASD). International Journal of Interactive Mobile Technologies (iJIM). 2017;11(1):4.
34. Safi, MF, Sadrani BA, Mustafa, A. Virtual voice assistant applications improved expressive verbal abilities and social interactions in children with autism spectrum disorder: A single-subject experimental study. International Journal of Developmental Disabilities. 2023;69(4):555-567.
35. Karamanoli MP. The application of augmented reality for intervention to people with autismspectrum disorders, IOSR Journal of Mobile Computing & Application. 2017;4(2):42–51.
36. Schmidt ΜΜ, Glaser Ν. Piloting an adaptive skills virtual reality intervention for adults with autism: Findings from user-centered formative design and evaluation. Journal of Enabling Technologies. 2021;15(3):137–158.
37. Serret S, Hun S, Iakimova G, Lozada J, Anastassova M, Santos A, et al. Facing the challenge of teaching emotions to individuals with low- and high-functioning autism using a new serious game: A pilot study. Molecular Autism. 2014;5(1):37.
38. Lahiri U. Scope of virtual reality to autism intervention. A Computational View of Autism.2020 Jul:83–130.
39. Maseri M, Mamat M, Yew HT, Chekima A. The implementation of application software to improve verbal communication in children with autism spectrum disorder: A Review. Children. 2021;8(11):1001.
Correspondence
Koutsaftiki Chrysi
Sof. Venizelou 77, Halandri, PC 15232
Μ. 6970061238
e-mail: kochrysa@yahoo. com
Artificial Intelligence and COVID-19 pandemic: tracking and evaluation of cases in the general population
Introduction: Covid-19 pandemic, compared to the past, had technology’s contribution as its most valuable ally. Through achievements such as artificial intelligence, the simultaneous collaboration of independent research centers around the world has become possible, to identify cases, monitor them, ensure their isolation and trace their contacts, but also to search for suitable therapeutic molecules-substances and development of effective vaccines. An artificial intelligence system that processes information from airlines issued a warning about the arrival of Covid-19 on December 31, 2019, simultaneously as the clinical detection of the first cases, which, however, were not evaluated at the time for the risk they posed.
Method: Articles were searched in the international literature, in reputable websites such as Pub Med, Google Scholar, using key words “COVID-19, artificial intelligence, outbreaks, treatment”.
Results: Systems based on Artificial Intelligence have been successfully used in the tracking and management of cases, in recording the symptoms of the initially unknown disease COVID-19, in the development of targeted treatments and vaccines, with such speed that humanity has never seen before. Long Covid-19 was also studied due to artificial intelligence as well as it contributed to the evaluation of health measures taken by governments. At stake is the invasion of privacy and information overload.
Conclusions: It is clear, therefore, that today more than ever, the absolute cooperation of technology and classical sciences is needed, in order to overcome, in the best and shortest way, the difficulties in the continuous struggle against acute and chronic diseases.
Paediatric department, ‘Rafina’ Health Care Centre, Rafina-Attika, Greece
Chrysi Koutsaftiki
Theodoros Sergentanis
Nair Tonia Vasilakou
Eleni Kornarou
Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
Pub Med, Google Scholar,
(19).
Johns Hopkins
Center of Science and Engineering, στην
Covid-19 σε πραγματικό
Βιβλιογραφία:
1. Mammas IN, Liston M, Koletsi P, Vitoratou DI, Koutsaftiki C, Papatheodoropoulou A, Kornarou H, Theodoridou M, Kramvis A, Drysdale SB, Spandidos DA. Insights in paediatric virology during the COVID-19 era (Review). Med Int (Lond). 2022 May 17;2(3):17. doi: 10.3892/ mi.2022.42. PMID: 36698505; PMCID: PMC9829203.
2. Bansal A, Padappayil RP, Garg C, et al. 2020 Utility of artificial intelligence amidst the COVID-19 pandemic: a review. J Med Syst 1;44(9):156. doi: 10.1007/s10916-020-01617-3.
3. Yadav AK, Verma D, Kumar A, et al. 2021 The perspectives of biomarker-based electrochemical immunosensors, artificial intelligence and the Internat of medical things toward COVID-19 diagnosis and management. Mater Today Chem 20:100443. doi: 10.1016/j. mtchem.2021.100443. Epub 2021 Feb 11.
4. Lin L, Hou Z. 2020 Combat COVID-19 with artificial intelligence and big data. J Travel Med 20;27(5):taaa080. doi: 10.1093/jtm/taaa080
5. Rasheed J, Jamil A, Hameed AA, et al. 2021 COVID-19 in the age of artificial intelligence: a comprehensive review. Interdiscip Sci 22;1-23. doi: 10.1007/s12539-021-00431-w. Online ahead of print.
6. Vaid S, Kalantar R, Bhandari M. 2020 Deep Learning COVID-19 detection bias: accuracy through artificial intelligence. Int Orthop. 44(8):1539-1542. doi: 10.1007/s00264-020-04609-
7. Epub 2020 May 27.
7. Kumar A, Gupta PK, Srivastava A. 2020 A review of modern technologies for trackling COVID-19 pandemic. Diabetes Metab Syndr. 2020 Jul-Aug;14(4):569-573. doi: 10.1016/j. dsx.2020.05.008. Epub 2020 May 7. PMID: 32413821
8. Malik YS, Sircar S, Bhat S, et al. 2020 How artificial intelligence may help the COVID-19 pandemic: pitfalls and lessons for the future. Rev Med Virol. 19;e2205. doi: 10.1002/ rmv.2205. Online ahead of print.
9. Schultz MB, Vera D, Sinclair DA. 2020 Can artificial intelligence identify effective COVID-19 therapies? EMBO Mol Med. 7;12(8):e12817. doi: 10.15252/emmm.202012817. Epub 2020 Jul 7. PMID: 32569446
10. Turing AM. 1936 Proc Lond Math Soc. Series 2(42):230-265.
11. Miller DD, Brown EW. 2018 Artificial Intelligence in medical practice: the question to the answer? Am J Med. 131(2):129-133. doi: 10.1016/j.amjmed.2017.10.035. Epub 2017 Nov 7. PMID: 29126825
12. Liang H, Tsui BY, Ni H, et al. 2019 Evaluation and accurate diagnosis of pediatric diseases using artificial intelligence. Nat Med. 25(3):433-438. doi: 10.1038/s41591-018-0335-9. Epub 2019 Feb 11. PMID: 30742121
13. Srinivasa Rao AS, Vazquez JA. 2020 Identification of COVID-19 can be quiker through artifitial intelligence framework using a mobile phone-based survey when cities and towns are under quarantine. Infect Control Hosp Epidemiol 41(7):826-830. doi: 10.1017/ice.2020.61. Epub 2020 Mar 3.
14. Ruiz Estrada MA. 2020 The uses of drones in case of massive Epidemics contagious diseases relief humanitarian aid: Wuhan-COVID-19 crisis. SSRN Electron J https://doi. org/10.2139/ssrn.3546547
15. Gilbert M, Pullano G, Pinotti F, et al. 2020 Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study. The Lancet 395(10227):871-7
16. Makridakis S. 2017 The forthcoming artificial intelligence (AI) revolution: its impact on society and firms. Futures 90: 46-60
17. World Health Organization. 2020 Coronavirus (COVID-19) outbreak URL: https://www. who.int/westernpacific/emergencies/covid-19 [accessed 2020-05-06]
18. Alimadadi A, Aryal S, Manandhar I, et al. 2020 Artificial intelligence and machine
learning to fight COVID-19. Physiol Genomics. 1;52(4):200-202. doi:10.1152/physiolgenomics.00029.2020. Epub 2020 Mar 27.
19. Menni C, Valdes AM, Freidin MB, et al. 2020 Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med 26:1037-1040.
20. Dong E, Du H, Gardner L. 2020 An interactive web-based dashboard to track COVID-19 in real time. Lanset Infect. Dis 20:533-534.
21. Bastawrous A, Armstrong MJ. 2013 Mobile health use in low- and high-income countries: an overview of the peer-reviewed literature. J R Soc Med. 106(4):130-42. doi: 10.1177/0141076812472620
22. Li L, Qin L, Xu Z, et al. 2020 Artificial intelligence distinguishes COVID-19 from community acquired pneumonia on chest CT. Radiology. https://doi.org/10.1148/radiol.2020200905
23. Jiang X, Coffee M, Bari et al. 2020 Towards an artificial intelligence framework for datadriven prediction of coronavirus clinical severity. Comput Mater Continua 63:537-51.
24. Ghose A, Roy S, Vasdev N, et al. 2020 The emerging role of artificial intelligence in the fight against COVID-19. Eur Urol. 78(6):775-776. doi: 10.1016/j.eururo.2020.09.031. Epub 2020 Sep 17. PMID: 32994064
25. Blease C, Kaptchuk TJ, Bernstein MH, et al. 2019 Artificial intelligence and the future of primary care: exploratory qualitative study of UK General Practitioners’ views. J Med Internet Res. 21(3): el2802. doi: 10.2196/12802
26. World Health Organization.2016 [2018-10-05]. Draft global strategy on human resourses for health: Workforce 2030 http://who.int/gb/ebwah/pbf_files/WHA69/A69_38-en.pdf webcite
27. Pfaff ER, Girvin AT, Bennett TD, Bhatia A, Brooks IM, Deer RR, Dekermanjian JP, Jolley SE, Kahn MG, Kostka K, McMurry JA, Moffitt R, Walden A, Chute CG, Haendel MA; N3C Consortium. Identifying who has long COVID in the USA: a machine learning approach using N3C data. Lancet Digit Health. 2022 Jul;4(7):e532-e541. doi: 10.1016/S2589-7500(22)000486. Epub 2022 May 16. PMID: 35589549; PMCID: PMC9110014.
Correspondence
Alexios Mavroudis MD,Msc. Erithrou stavrou terma
c.p 22131, Tripoli Arcadia, Greece
T. +306978699611
e-mail: alexis.mavroudis@ yahoo.gr
Nanovesicles in chronic pediatric inflammation
Αlexios Mavroudis
Summary
Nanovesicles or exosomes are biological structures of rejection from the cellular environment with a large number of functions. They participate in intercellular communication, while at the same time they play a primary role in the diagnosis and treatment of chronic diseases. Their action has been associated, mainly, with immune responses, inflammation, cardiovascular diseases, diseases related to the central nervous system, as well as with processes of selective presence of molecular biomarkers that help in the interpretation and management of pediatric clinical practice. Analogous molecules are also considered the specific sequences of non-coding RNAs (miRNAs), which alter gene regulation and express a defined clinical phenotype according to the standards of personalized medicine. These are, therefore, molecules, which are projected for diagnostic and therapeutic purposes and serve for the identification and clinical course of diseases. They also present an evolutionary process during the disease unchanged in stressful conditions, but adapted to the pathological background.
1. Michael Craig Larson, Cheryl A Hillery, Neil Hogg. Circulating membrane-derived microvesicles in redox biology. Free Radic Biol Med 2014 Aug:73:214-28.
2. Guillaume van Niel, Gisela D'Angelo, Graça Raposo. Shedding light on the cell biology of extracellular vesicles. Nat Rev Mol Cell Biol 2018;19(4):213-228.
3. Jacopo Meldolesi. Exosomes and Ectosomes in Intercellular Communication. Curr Biol 2018 Apr 23;28(8):R435-R444.
4. Escher R, Breakey N, Lämmle B. Severe COVID-19 infection associated with endothelial activation. Thromb Res. 2020 Jun;190:62.
5. Demyanets S, Stojkovic S, Huber K, Wojta J. The Paradigm Change of IL-33 in Vascular Biology. Int J Mol Sci. 2021 Dec 10;22(24).
6. Stojkovic S, Thulin Å, Hell L, Thaler B, Rauscher S, Baumgartner J, et al. IL-33 stimulates the release of procoagulant microvesicles. From human monocytes and differentially increases tissue factor in human monocyte subsets. Thromb Haemost. 2017 Jun 28;117(7): 1379–90.
7. Ley K, Laudanna C, Cybulsky MI, Nourshargh S. Getting to the site of inflammation: the leukocyte adhesion cascade updated. Nat Rev Immunol. 2007 Sep;7(9):678–89.
8. Muller WA. Mechanisms of transendothelial migration of leukocytes. Circ Res. 2009 Jul 31;105(3):223–30.
9. Ohsuzu F. The roles of cytokines, inflammation and immunity in vascular diseases. J Atheroscler Thromb. 2004;11(6):313–21.
10. Williams MR, Azcutia V, Newton G, Alcaide P, Luscinskas FW. Emerging mechanisms of neutrophil recruitment across endothelium. Trends Immunol. 2011 Oct;32(10):461–9.
11. Kuijpers MJE, Heemskerk JWM, Jurk K. Molecular Mechanisms of Hemostasis, Thrombosis and Thrombo-Inflammation. Int J Mol Sci. 2022 May 23;23(10).
12. Rienk Nieuwland, Pia R-M Siljander. A beginner’s guide to study extracellular vesicles in human blood plasma and serum. J Extracell Vesicles. 2024.
13. Charysse Vandendriessche, Dimitrios Kapogiannis, Roosmarijn E Vandenbroucke. Biomarker and therapeutic potential of peripheral extracellular vesicles in Alzheimer's disease. Adv Drug Deliv Rev. 2022 Nov:190:114486.
14. Eun J Park, Michael G Appiah, Phyoe K Myint, Arong Gaowa, Eiji Kawamoto, Motomu Shimaoka. Exosomes in Sepsis and Inflammatory Tissue Injury. Curr Pharm Des 2019;25(42):4486-4495.
15. Ya Liu 1, Gang Yu, Yan-Yan Ding, Yong-Xia Zhang. Research Article Expression of miR155 in Serum Exosomes in Children with Epilepsy and Its Diagnostic Value.
16. Poonam Nagpal, Dante B Descalzi-Montoya, Niraj Lodhi. The circuitry of the tumor microenvironment in adult and pediatric Hodgkin lymphoma: cellular composition, cytokine profile, EBV, and exosomes. Cancer Rep (Hoboken) 2021 Apr;4(2):e1311.
17. Alireza Asef, Esmaeil Mortaz, Hamidreza Jamaati, Aliakbar Velayati. Immunologic Role of Extracellular Vesicles and Exosomes in the Pathogenesis of Cystic Fibrosis. Tanaffos 2018 Feb;17(2):66-72.
18.
19. Richard W. Carthew, Erik j. Sontheimer. Origins and mechanisms of miRNA and siRNAs. Cell 2009 Feb 20;136(4):642-55.
20. Sijie Jiang, Shaobing Xie, Ruohao Fan, Qingping Tang, Hua Zhang, Fengjun Wang et al. Exosomes Derived hsa-miR-4669 as a Novel Biomarker for Early Predicting the Response of Subcutaneous Immunotherapy in Pediatric Allergic Rhinitis. J Inflamm Res. 2022 Sep 3:15:5063-5074.
21. Abdelnaby Khalyfa, David Gozal. Exosomal miRNAs as potential biomarkers of cardiovascular risk in children. J Transl Med. 2014 Jun 10:12:162.
22. Angela Galardi, Marta Colletti, Virginia Di Paolo, Patrizia Vitullo, Loretta Antonetti, Ida Russo et al. Exosomal MiRNAs in Pediatric Cancers. Int J Mol Sci. 2019 Sep 17;20(18):4600.
23. Subhash B Arya, Samuel P Collie, Carole A Parent. The ins-and-outs of exosome biogenesis, secretion, and internalization. Trends Cell Biol. 2024 Feb;34(2):90-108.
Correspondence
Vasiliki Gketsi
60, General Makrigiannis Avenue, PC 454 45 Ioannina
T. +302651080785
Μ. 6945398479
e-mail: vikigetsi@gmail.com
A 14.5 year-old adolescent girl with atypical restrictive type of anorexia nervosa: the difficulty in diagnosis and acceptance
Anorexia nervosa is a serious mental illness with high rate of complications and the highest mortality rate of all mental illnesses. It usually manifests in adolescence, even during early puberty. Although people of any age, gender and socioeconomic status can be affected, the 90% of patients are female. There are two types of anorexia nervosa: (a) the restrictive one, with reduction of food intake, and (b) the type with episodes of binge eating/purgative use. The diagnosis is based on well-defined criteria. Anorexia nervosa is characterized as "atypical" when all criteria are met, with the exception of the weight criterion, thus when, despite significant weight loss, body weight and Body Mass Index (BMI) remain within normal limits. We present the case of a 14.5-year-old girl with atypical restrictive type of anorexia nervosa and we point out the difficulties that arise when documenting the diagnosis on one hand and getting the family to accept it on the other hand. Moreover, we highlight the role of the pediatrician in the early diagnosis of this serious and potentially fatal disorder, since he is usually the first person to evaluate the young patient, often for an unrelated reason, as it is described in our case.
Paediatric Department, General Hospital of Ioannina “G. Hatzikosta”, Ioannina, Greece
Iouliani Koullourou
CAMHS (Child and Adolescent Mental Health Services), Psychiatric Department, University Hospital of Ioannina, Ioannina, Greece
and Classification Manual of Mental Disorders – Fifth Edition” (DSM-5, APA 2013) (4)
“International Classification of Diseases, Eleventh Revision” (ICD 11) (5)
“Diagnostic and Classification Manual of Mental Disorders – FifthEdition” (DSM-5, APA 2013) [4] και “International Classification of Diseases, Eleventh Revision” (ICD 11) (5),
1. Herpertz-Dahlmann B, Dahmen B. Children in Need-Diagnostics, Epidemiology, Treatment and Outcome of Early Onset Anorexia Nervosa. Nutrients. 2019 Aug 16;11(8):1932. doi: 10.3390/nu11081932. PMID: 31426409; PMCID: PMC6722835.
2. Irwin, M. Early onset anorexia nervosa. South Med. J. 1984, 77, 611–614.
3. Russell, G.F. Premenarchal anorexia nervosa and its sequelae. J. Psychiatr. Res. 1985, 19, 363–369.
4. American Psychiatric Association (APA) Guidelines. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; DSM-5; American Psychiatric Association: Arlington, VA, USA, 2013. Feeding and eating Disorders. P 338-345.
5. WHO ICD-11. Available online: https://icd.who.int/en/ (accessed on 15 July 2019).CODE:
6B80.
6. Walker T, Watson H J, Leach D J, McCormack J, Tobias K,et al. Comparative study of children and adolescents referred for eating disorder treatment at a specialist tertiary setting. Int. J. Eat. Disord. 2014, 47, 47–53.
7. Peebles, R.; Wilson, J.L.; Lock, J.D. How do children with eating disorders differ from adolescents with eating disorders at initial evaluation? J. Adolesc. Health 2006, 39, 800–805.
8. Steinhausen H.-C., Jensen C.M. Time trends in lifetime incidence rates of first-time diagnosed anorexia nervosa and bulimia nervosa across 16 years in a Danish nationwide psychiatric registry study. Int. J. Eat. Disord. 2015;48:845–850. doi: 10.1002/eat.22402.
9. Favaro A., Caregaro L., Tenconi E., Bosello R., Santonastaso P. Time trends in age at onset of anorexia nervosa and bulimia nervosa. J. Clin. Psychiatry. 2009;70:1715–1721. doi: 10.4088/JCP.09m05176blu.
10. Cruz A.M., Gonçalves-Pinho M., Santos J.V., Coutinho F., Brandão I., Freitas A. Eating disorders-related hospitalizations in Portugal: A nationwide study from 2000 to 2014. Int. J. Eat. Disord. 2018;51:1201–1206. doi: 10.1002/eat.22955.
11. 21. Cost J, Krantz MJ, Mehler PS. Medical complications of anorexia nervosa. Cleve Clin J Med. 2020 Jun;87(6):361-366. doi: 10.3949/ccjm.87a.19084. PMID: 32487556.
12. Miller K.K. Endocrine dysregulation in anorexia nervosa update. J. Clin. Endocrinol. Metab. 2011;96:2939–2949. doi: 10.1210/jc.2011-1222.
13. Herpertz-Dahlmann B., Holtkamp K., Konrad K. Eating disorders: Anorexia and bulimia nervosa. Handb. Clin. Neurol. 2012;106:447–462.
14. Rosen D.S., American Academy of Pediatrics Committee on Adolescence Identification and management of eating disorders in children and adolescents. Pediatrics. 2010;126:1240–1253. doi: 10.1542/peds.2010-2821.
15. Hedman A, Breithaupt L, Hübel C, Thornton L M, Tillander A, et al. Bidirectional relationship between eating disorders and autoimmune diseases. J. Child Psychol. Psychiatry. 2019;60:803–812. doi: 10.1111/jcpp.12958.
16. KhalifaI and Goldman R. Anorexia nervosa requiring admission in adolescents. Canadian Family Physician February 2019, 65 (2) 107-108;
17. Olivares JL, Vázquez M, Fleta J, Moreno LA, Pérez-González JM, Bueno M. Cardiac findings in adolescents with anorexia nervosa at diagnosis and after weight restoration. Eur J Pediatr 2005;164(6):383-6. Epub 2005 Mar 15.
18. Yahalom M, Spitz M, Sandler L, Heno N, Roguin N, Turgeman Y. The significance of bradycardia in anorexia nervosa.Int J Angiol 2013;22(2):83-94.
19. American Academy of Pediatrics, Committee on Adolescence. Identifying and treating eating disorders. Pediatrics 2003;111(1):204-11.
20. Sachs KV, Harnke B, Mehler PS, Krantz MJ. Cardiovascular complications of anorexia nervosa: a systematic review. Int J Eat Disord 2016; 49(3):238–248. doi:10.1002/eat.22481.
21. Rautou PE, Cazals-Hatem D, Moreau R, et al. Acute liver cell damage in patients with anorexia nervosa: a possible role of starvation-induced hepatocyte autophagy. Gastroenterology 2008; 135(3):840–848.e1–e3. doi:10.1053/j.gastro.2008.05.055CrossRefPubMedGo ogle Scholar
22. Rosen E, Sabel AL, Brinton JT, Catanach B, Gaudiani JL, Mehler PS. Liver dysfunction in patients with severe anorexia nervosa. Int J Eat Disord 2016; 49(2):151–158. doi:10.1002/ eat.22436
23. Lock J, Le Grange D. Treatment Manual for Anorexia Nervosa: A Family-Based Approach. 2nd ed. Guilford Press, New York, NY2012
24. Muratore AF, Attia E. Current Therapeutic Approaches to Anorexia Nervosa: State of the Art. Clin Ther. 2021 Jan;43(1):85-94. doi: 10.1016/j.clinthera.2020.11.006. Epub 2020 Dec 5. PMID: 33293054; PMCID: PMC8221037.
25. Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatry. 2010 Oct;67(10):1025-32. doi: 10.1001/ archgenpsychiatry.2010.128. PMID: 20921118; PMCID: PMC3038846.
Correspondence
Elpidoforos Mantadakis
T. +302551351424
e-mail: emantada@med. duth.gr
Labial ulcers as initial manifestation of acute EBV infection in a nonsexually active teenage girl
Anna Papazoglou, Vassiliki Konstantinidou, Elpidoforos Mantadakis
Abstract
We report the case of a previously healthy non-sexually active 14-year-old girl who presented with genital ulcers due to infectious mononucleosis. Remarkably, our patient exhibited fever and genital ulcers before the manifestation of typical symptoms of EpsteinBarr virus (EBV) acute infection that became evident approximately 10 days later. She was treated with intravenous fluids and a topical antibiotic ointment. This report underscores the importance of considering infectious mononucleosis in the differential diagnosis of individuals with genital ulcers, particularly those who are non-sexually active.
Department of Pediatrics, University General Hospital of Alexandroupolis
1. Damania B, Kenney SC, Raab-Traub N. Epstein-Barr virus: Biology and clinical disease. Cell. 2022;185(20):3652-70.
2. Womack J, Jimenez M. Common questions about infectious mononucleosis. Am Fam Physician. 2015;91(6):372-6.
3. Hoover K, Higginbotham K. Epstein-Barr Virus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024
4. Lorenzo CV, Robertson WS. Genital ulcerations as presenting symptom of infectious mononucleosis. J Am Board Fam Med. 2005;18(1):67-8.
5. McKenna G, Edwards S, Cleland H. Genital ulceration secondary to Epstein Barr virus infection. Sex Transm Infect. 1994;70(5):356-7.
6. Barnes CJ, Alió AB, Cunningham BB, Friedlander SF. Epstein–Barr virus‐associated genital ulcers: An under‐recognized disorder. Pediatr Dermatol. 2007;24(2):130-4.
7. Taylor S, Drake SM, Dedicoat M, Wood MJ. Genital ulcers associated with acute EpsteinBarr virus infection. Sex Transm Infect. 1998;74(4):296-7.
8. Halvorsen J, Brevig T, Aas T, Skar A, Slevolden E, Moi H. Genital ulcers as initial manifestation of Epstein-Barr virus infection: Two New Cases and a Review of the Literature. Acta Derm Venereol. 2006;86(5):439-42.
9. Brown ZA, Stenchever MA. Genital ulceration and infectious mononucleosis: Report of a case. Am J Obstet Gynecol. 1977;127(6):673-4.
10. Portnoy J, Ahronheim GA, Ghibu F, Clecner B, Joncas JH. Recovery of Epstein–Barr virus from genital ulcers. N Engl J Med. 1984;311(15):966-8.
11. Hudson L. Necrotizing genital ulcerations in a premenarcheal female with mononucleosis. Obstet Gynecol. 1998;92(4):642-4.
12. Farhi D, Wendling J, Molinari E, Raynal J, Carcelain G, Morand P, et al. Non–sexually related acute genital ulcers in 13 pubertal girls: A clinical and microbiological study. Arch Dermatol. 2009;145(1):38-45.
13. Cheng SX, Chapman MS, Margesson LJ, Birenbaum D. Genital ulcers caused by Epstein-Barr virus. J Am Acad Dermatol. 2004;51(5):824-6.
14. Leigh R, Nyirjesy P. Genitourinary manifestations of Epstein-Barr virus infections. Curr Infect Dis Rep. 2009;11(6):449-56.
15. Lampert A, Assier-Bonnet H, Chevallier B, Clerici T, Saiag P. Lipschutz’s genital ulceration: a manifestation of Epstein-Barr virus primary infection. Br J Dermatol. 1996;135(4):663-5.
16. Sisson BA, Glick L. Genital ulceration as a presenting manifestation of infectious mononucleosis. J Pediatr Adolesc Gynecol. 1998;11(4):185-7.
17. Mourinha V, Costa S, Urzal C, Guerreiro F. Lipschütz ulcers: uncommon diagnosis of vulvar ulcerations. BMJ Case Rep. 2016;bcr2015214338.
ΣΥΝΑΔΕΛΦΙΚΑ
1.
2.
3. Βραβευμένες
4. Ερευνητικές μελέτες
5.
6.
7. Επίκαιρα θέματα
τραπεζών
8. Θέματα εκπαίδευσης και οργάνωσης υγείας
9. Ενδιαφέρουσες περιπτώσεις
10. Σύντομα νέα
11. Βραχείες δημοσιεύσεις
12. Επιστολές προς τη σύνταξη
13.
14.
•
International Committee of Medical Journal Editors/ Uniform Requirements for Manuscripts Submitted to Biomedical Journals, (www.icmje.org και www.icmje.org/icmje.pdf).
Cumulated Index Medicus [List of Journals Indexed in Index Medicus (www.nlm.nih.goν/bsd/ uniform_requirements.html)].
1999;59:272-279.
Proesmans W. Bartter syndrome and its neonatal νariant. Eur J Pediatr 1997;156:669-679.
Flyvbjerg Α. Role of growth hormone, insulin-like growth factors (IGFs) and IGF-binding proteins in the renal complications of diabetes. Kidney Ιnt 1997;52 (60 Suppl):S12-S19. Χωρίς
National Institutes of Health Consensus Deνelopment Conference. Neurofibromatosis conference statement. Arch Neurol1988;45:575-578.
Προσδιορισμός τύπου άρθρου:
Schreiner GF, Lange L. Ethanol modulation of macrophage influx in glomerulonephritis [Abstract]. J Am Soc Nephrol 1991;2:562.
Should antileukotriene therapies be used instead of inhaled corticosteroids in asthma? [Editorial]. Am J Respir Crit Care Med 1998;158:1697-1701.
Clark AG, Barratt ΤΜ. Steroid-responsiνe nephrotic syndrome. Ιn: Barratt ΤΜ, Arner ED, Harmon WE, editors. Pediatric Nephrology. 4th ed. Baltimore: Lippincott William Wilkins; 1999. p. 742.
Σύγγραμμα ή μονογραφία:
Gorlin RJ, Cohen ΜΜ, Leνin LS. Syndromes of the head and neck. 3rd ed. New York: Oxford Uniνersity Press; 1990.
Δημοσίευση
Bauer ΑW. The two definitions of bacterial resistance. In: Smith AJ, Rogers CA, eds. Proceedings of the Third International Congress of Chemotherapy; 1962 May 29-31; New York: International Society of Chemotherapy; 1963. p. 484-500.
Διδακτορική διατριβή: Παπαδόπουλος
Αθηνών; 1979.
Kaplan SJ. Post hospital home health care: the elderly’s access and utilization [dissertation]. St. Louis (Μο): Washington Univ.;1995.
III. CD-ROM
Andersoη SC, Poulsen ΚΒ. Anderson’s electronic atlas of hematology [CD-ROM]. Philadelphia: Lippincott Williams & Wilkins; 2002.
IV. ΣΤΟ ΔΙΑΔΙΚΤΥΟ Άρθρο σε περιοδικό: Abood S. Quality improνement initiatiνe in nursiηg homes: the ΑΝΑ acts in an adνisory role. Am J Nurs [Internet]. 2002 Jun:
Μονογραφία: Foley ΚΜ, Gelbaηd Η, editors. Improving palliative care for cancer [Monograph, Internet]. Washington: National Academy Press; 2001.
Webpage: http://www.nap.edu/books/0309074029/html Ιστοσελίδες: Cancer-Pain.org [Webpage, Internet]. New York: Association of Cancer Online Resources, Ιnc.; 2002: http://www.cancer-pain.org/
